(Specimen of Affidavit required for PSARA licence)

AFFIDAVIT

I, -------------------------- son of / daughter of ---------------------------resident of ------

--------------------------------------- do hereby solemnly declare and affirm as follows:

(1) That I am a citizen of India. I bear a valid Indian Passport No.--------------------

issued by Regional Passport Office at --------------------. OR I have applied for

an Indian Passport to the Regional Passport Officer at --------------------. (strike out whichever is not applicable).

(2) That the Private Security Agency “ ----------------------------------- ” is an old-

existing OR a newly registered enterprise/ corporate body (Private limited

Company / Public limited Company / a Firm / a Society / a Cooperative society /a

Trust / a Partnership / an Association of persons and the deponent is its Sole

proprietor OR one of its directors/ partners /trustees/ member /promoters /

share holders who has applied for grant of license to engage in the business of

providing private security through the agency named above. (strike out whichever is not applicable).

(3) That I undertake to commence the business of providing security within the six

months of obtaining licence and shall also furnish other relevant information asked

for by the Controlling authority and registrations such as ESI, EPF, ITR, STR etc

mandatory as per law to run the business of providing security to the Controlling

authority during this period.

(4) That I have not been convicted of an offence in connection with promotion,

formation or management of a company (any fraud or misfeasance committed by

me in relation to the company), including an un-discharged insolvent.

(5) That I have not been convicted by a competent court for an offence, the prescribed

punishment for which is imprisonment of not less than two years.

(6) That I have no links with any organization or association which is banned under

any law on account of their activities which pose threat to national security or

public order or there is information about such a person indulging in activities

which are prejudicial to national security or public order.

(7) That I have not been dismissed or removed from Government service on grounds of

misconduct or moral turpitude.

(8) That I undertake to ensure imparting of requisite training and skills as prescribed

under Section 9 (2) of PSAR Act 2005 to the private security guards and

supervisors employed by applicant’s above named agency.

(9) That I shall abide by all the conditions / requirements prescribed under section 11

of PSAR Act 2005.

(10) That no case has been registered with the police or pending in a court of law

involving the applicant-deponent.

(11) That the Private Security Agency “ -------------------” has no foreign equity. OR

That the total foreign equity combined in respect of all the

directors/partners/associates/promoters/share holders is less than 49%. Further, the

actual foreign equity is ---------- % of the total investment and my share in the

foreign equity is ------- % out of my total contribution of --------%. (strike out whichever is not applicable).

(12) That the Private Security Agency “ -------------------- ” is neither a ‘branch’/

‘mushroom’ company of any ‘holding company’ whose main business is based in

any foreign country nor any of its directors/promoters/partners/members is a

foreigner.

(13) That I undertake to strictly abide by various provisions regarding the Payment of

wages act, Industrial disputes act and other acts as laid down under the Schedule to

section 13(1)(j) of the PSAR Act, 2005.

(14) That neither the applicant nor any of the directors/partners/ members or employees

of the Private Security Agency “ ---------------------- ” hold any firearms licence or

are in possession of any firearms or ammunition. OR That the detail of

firearms licence(s) and arms & ammunition already in possession of the

applicant/directors/partners and employees of the Private Security Agency

“ --------------------- ” have been furnished by me to the Controlling Authority along

with the Form-V. (strike out whichever is not applicable).

(15) That I have carefully gone through and understood the provisions of Private

Security Agencies (Regulation) Act, 2005 and Rules-2009 prescribed there under

and undertake that I shall abide by the prescribed provisions under the above

mentioned Act & Rules and various instructions / guidelines issued by the

Controlling Authority from time to time in letter & spirit.

(16) That in case any information found to be incorrect or false the licence issued to the

Private Security Agency “ ---------------------- ” to engage in the business of

providing security shall be cancelled.

Place------------ Deponent

Date-------------

Verification

I solemnly declare and affirm that the information furnished by me is factually

correct and nothing is false or incorrect or has been suppressed, concealed or distorted therein

and the undertaking given above in the shape of affidavit is without any pressure, coercion,

influence and it is purely voluntary, after consulting the other stake holders in the Agency /

Training Institute and the same is once again verified to be factually correct to the best of my

knowledge and belief.

Place------------ Deponent

Date-------------